NEW YORK, NY (Sept. 13, 2017) -- New data confirm that suicide attempts among U.S. adults are on the rise, with a disproportional effect on younger, socioeconomically disadvantaged adults with a history of mental disorders. The study, by researchers at Columbia University Medical Center (CUMC) and New York State Psychiatric Institute (NYSPI), was published today in JAMA Psychiatry.
"Attempted suicide is the strongest risk factor for suicide, so it's important that clinicians know just who faces the highest risk so that we can do a better job of preventing suicides from happening," said Mark Olfson, MD, MPH, professor of psychiatry and epidemiology at CUMC and lead author of the study.
Between 2004 and 2014, the annual suicide rate increased from 11 percent to 13 percent per 100,000 people. While the increase in suicide attempts mirrors this national trend, the study revealed some important differences in risk factors for attempted suicide versus completed suicide. For example, while middle-aged adults (aged 45-64 years) had the highest suicide rate, young adults (aged 21-34 years) had the biggest increase in suicide attempts. And while suicide attempts were higher among women than men, more men completed suicide.
The study is based on National Institutes of Health surveys performed in 2004-05 and again in 2012-13, in which nearly 70,000 adults answered questions about the occurrence and timing of suicide attempts. The study period included the economic downturn beginning in 2007.
In the 2012-13 survey, respondents who were unemployed, less educated, and had lower family income were significantly more likely to report a recent suicide attempt.
The two groups shared several clinical risk factors, including depression, anxiety, and substance use disorders. A history of violent behavior or self-injury also increased risk for suicide attempt or suicide.
"The patterns seen in this study suggest that clinical and pubic health efforts to reduce suicide would be strengthened by focusing on younger patients who are socioeconomically disadvantaged and psychiatrically distressed," said Dr. Olfson.
Jeffrey Lieberman, MD, chair of the department of psychiatry at CUMC and former American Psychiatric Association President commented that "Dr. Olfson's report provides a warning signal of the harmful consequences of ignoring mental illness and an exhortation to improve mental health care in the U.S.
The study, titled "National Trends in Suicide Attempts," was published in JAMA Psychiatry on August 20, 2017. The authors are Mark Olfson, MD, MPH (CUMC and NYSPI); Carlos Blanco, MD, PhD (National Institute on Drug Abuse); Melanie Wall, PhD, (CUMC and NYSPI); Shang-Min Liu, MS, (CUMC and NYSPI); Tuishi D. Saha, PhD, (National Institute on Alcohol Abuse and Alcoholism (NIAAA)); Roger P Pickering, MS, (NIAAA); Bridget Grant, PhD, (NIAAA).
The authors report no financial conflicts of interest.
The study was supported by grants DA 019606 and MH 107452 from the National Institutes of Health.
New York State Psychiatric Institute and Columbia University Department of Psychiatry (NYSPI/Columbia Psychiatry).
New York State Psychiatric Institute (founded in 1896) and the Columbia University Department of Psychiatry have been closely affiliated since 1925. Their co-location in a New York State facility on the New York-Presbyterian/Columbia University Medical Center campus provides the setting for a rich and productive collaborative relationship among scientists and physicians in a variety of disciplines. NYSPI/Columbia Psychiatry is ranked among the best departments and psychiatric research facilities in the nation and has contributed greatly to the understanding of and current treatment for psychiatric disorders. The Department and Institute are home to distinguished scientists noted for their clinical and research advances in the diagnosis and treatment of depression, suicide, schizophrenia, bipolar and anxiety disorders and childhood psychiatric disorders. Their combined expertise provides state of the art clinical care for patients, and training for the next generation of psychiatrists and psychiatric researchers.
Columbia University Medical Center provides international leadership in basic, preclinical, and clinical research; medical and health sciences education; and patient care. The medical center trains future leaders and includes the dedicated work of many physicians, scientists, public health professionals, dentists, and nurses at the College of Physicians and Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. Columbia University Medical Center is home to the largest medical research enterprise in New York City and State and one of the largest faculty medical practices in the Northeast. The campus that Columbia University Medical Center shares with its hospital partner, NewYork-Presbyterian, is now called the Columbia University Irving Medical Center. For more information, visit cumc.columbia.edu or columbiadoctors.org.